DEP WTC sample records, Oct 2001

NYC 9/11 Public Portal Document

IXJ Ntt I8‘e ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM OV. WESTCHESTER COUNTY LABORATORIES AND RESEARCH 2 Dana Road, Valhalla, New York 10595 ■ • (914)593-5575 NYS-ELAP No. 10108 Time/Date Set: Form A-70 (rev. 1/96)

Type (circle one): >M 11. — _ 34-2 4 —\2 i z80 4. Potable 3. Non Potable Treated Bottle rs: __________ 2. Non Potable 4. Other Chain of Custody? vesno 216 Time/Date Collec 4820/09/ Comments: --------------------- ------

Collected By: _ SAcKETT __ ___________ Agency Code:__ _ PWS #: _____ Source ID: Type Descriptor: _ Collected From: Bill to: Location’s/Individual’s Name 1 - ST A = A Asu AA/s Name/Company 2 Street ...................... .............. . — Street - City/StZip _ _________________________ City/St/Zip _ _______________ Identification of Source -. .. ... -.. ......... .. . Phone#: _ Fax#: Collection Point _6SSD — CA.CH, Bl? Check#: Amounts.

BACTERIOLOGICAL ANALYSIS ORGANIC POTABLE ANALYSIS, ORGANIC NONPOTABLE/SOLID ANALYSIS Lab#: _ Lab#: - (circle tests) (circle tests) 6 2S I A) . 1. Heterotrophic Plate (1.Trihalomethanes (524) ‘ _ 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) (2) Volatile Halocarbons (524) 2. Purgeable Aromatics (624/8260) 2. Coliform P/A (public supplies) (3.) Volatile Aromatics (524) 3. Acrolein & Acrylonitrile (624) 3. Coliform MPN (priv well, raw. stp) 4. Total Trihalomethane Potential (510) 4. Phthalates (625/8270) 4. Fecal Coliform (all samples) 5. Microextractables (504) 5. Organochlorine Pesticides (608/8081) 5. Microscopic 6. Pesticides (507) 6. PCB's (Arochlors) (608/8081) 6. Macroscopic /7.Pesticides/PCB screen (508) 7. Methoprene (616) 8. PCB as Decachlorobiphenyl (508A) 7.AR 8. Herbicides (EPA1978/8151) 8.»r:_______ 9. Herbicides (515) 9. Pesticides (SM18/6630) Refrigerated? yes no 10.) Pesticides (525) 10. Petroleum Hydrocarbon Scan (310-13) 11. Carbamate Pesticides (531) 11. Glycols Chlorinated:? yes no 12. Glyphosate (547) ) 12. Acid Extractables (625/8270) 13. Diquat (549) 13. Base Neutral Extractables (625/8270) Free Chlorine Res:, —ma/L 14. Chlorination Disinfection Byproducts (551) 14. GC/MS Semivolatile Unknown Scan ' ! Total Chlorine Res: _ mg/L 15. Haloacetic Acids (552) : 15. Purgeable Halocarbons (DEF) 16. Pesticides (SM18/6630) 16. Purgeable Aromatics (DEF) pH 17. Petroleum/Hydrocarbon Scan (310-13) 17. Pesticides/PCB’s (DEF) 18. Other: 18. Other:

INORGANIC ANALYSIS REQUESTED - Lab#: (circle tests) s i y _ . EW 5 1. Color 20. Acidity 39. Aluminum 59. Potassium 2. Turbidity 21. Alkalinity, as CaCOa 40. Antimony ■ 60. Selenium 3. pH 22. Bromide 41. Arsenic 61. Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 0 62. Sodium , : । 5. Corrosivity (temp:. °C) 24. Chloride / • . ; 43. Beryllium 44. Boron 63. Thallium (1/ 6. BOD (5 day) 25. Cyanide : ’ 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride . . 45. Cadmium 65. Zinc 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 46. Calcium, as CaCOa CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*2 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen. Nitrate as N : 48. Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent 68. Semi-violatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil an Grease 51.Copper ' • 70. Disk Deliverables 14. Solids, Settleable 33. Phenol 52. Iron TCLP volids: Suspended Total 17. Solids, Total Dissolved 34. Phosphorus Total as P 35. Phosphorus, Ortho as P 36. Sulfates 53.Lead / 54 Magnesium 55 Manganese 71 TCLP-Metals 72.TCLP-Pesticides 37. Surfactants 56. Mercury ) 73.TCLP-Herbicides 18. Solids, Total Volatile 74. TCLP-Volatiles 19. Other: ______ 38. UV254 57 Molybdenum 75.TCLP-BNAs * 58. Nickel

NYC-WTC_000026109